| Msk Clinic | |
|
12129 Rr 620 N Ste 610 Austin TX 78750-1086 | |
| (512) 900-7800 | |
| (833) 463-1693 |
| Full Name | Msk Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 12129 Rr 620 N Ste 610, Austin, Texas |
| Authorized Official Name and Position | Ibrahim Mansour (DOCTOR) |
| Authorized Official Contact | 5129007800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Msk Clinic 12129 Rr 620 N Ste 610 Austin TX 78750-1086 Ph: (512) 900-7800 | Msk Clinic 12129 Rr 620 N Ste 610 Austin TX 78750-1086 Ph: (512) 900-7800 |
| NPI Number | 1992400501 |
|---|---|
| Provider Enumeration Date | 04/03/2023 |
| Last Update Date | 10/11/2024 |
| Medicare PECOS PAC ID | 8820459456 |
|---|---|
| Medicare Enrollment ID | O20230731000784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992400501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ibrahim Mansour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578807590 PECOS PAC ID: 4082834841 Enrollment ID: I20140930002154 |
| Provider Name | Mahmoud M Khalaf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790149300 PECOS PAC ID: 1153604871 Enrollment ID: I20210721004181 |
| Provider Name | Jeevantha Nanayakkara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366129934 PECOS PAC ID: 8628510849 Enrollment ID: I20240604000158 |
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